HEALTH INFORMATION

Immunizations

Topic Overview

What are immunizations?

Immunizations save lives. They are the best way to help protect
you or your child from certain infectious diseases. They also help reduce the spread of disease to
others and prevent epidemics. Most are given as shots. They are sometimes
called vaccines, or vaccinations.

In many cases when you get a
vaccine, you get a tiny amount of a weakened or dead form of the organism that
causes the disease. This amount is not enough to give you the actual disease.
But it is enough to cause your
immune system to make
antibodies that can recognize and attack the organism
if you are ever exposed to it.

Sometimes a vaccine does not
completely prevent the disease, but it will make the disease much less serious
if you do get it.

Some immunizations are needed only one time.
Others require several doses over time to help your body be able to fight the disease (build immunity).

What are some reasons to get immunized?

Immunizations protect you or your child from dangerous
diseases.

They help reduce the spread of disease to others.

They are often needed for entrance into school or day care. And
they may be needed for employment or for travel to another country.

Getting immunized costs less than getting treated for the
diseases that the shots protect you from.

The risk of getting a
disease is much greater than the risk of having a serious reaction to the vaccine.

When immunization rates drop below a certain level, preventable diseases show up again. Often, these diseases are hard to treat. For example, measles outbreaks still occur in the U.S.

If you are a woman who is planning to get pregnant, talk
to your doctor about what immunizations you have had and what you may need to
protect your baby. And if you live with a pregnant woman, make sure your
vaccines are up-to-date.

Traveling to other countries may be
another reason to get immunized. Talk with your doctor months before
you leave, to see if you need any shots.

Immunizations start right after birth, and many are given
throughout a baby's first 23 months. Booster shots (the later doses of any
vaccines that need to be repeated over time) occur throughout life.

Fewer immunizations are needed after age 6. But older children and teens
need shots too (such as those for bacterial meningitis and for tetanus,
diphtheria, and whooping cough). Some shots are also given during adulthood
(such as a tetanus shot).

It is important to keep a good
record,
including a list of any reactions to the vaccines. When you enroll your child
in day care or school, you may need to show proof of immunizations. Your child
may also need the record later in life for college, employment, or travel.

Talk to your doctor if
you or your child plans to be in a group living situation, like a college
dormitory or summer camp. You may want certain shots, like those for meningitis.

What vaccines are recommended for adults?

The
vaccines you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans
but also on who you are in close contact with and what vaccines you had as a child.

Talk to your
doctor about which vaccines you need. Common adult vaccines include:

Flu.

Human papillomavirus (HPV).

Pneumococcal.

Shingles.

Tetanus, diphtheria, and pertussis.

In some states, pharmacists can give some of these shots.

What are the side effects of vaccines?

Most side
effects from vaccines are minor, if they occur at all. Ask your doctor or pharmacist about
the reactions that could occur. They may include:

Redness, mild swelling, or soreness where the shot was given.

A slight fever.

Drowsiness, crankiness, and poor appetite.

A mild rash 7 to 14 days after chickenpox or
measles-mumps-rubella shots.

Temporary joint pain after a measles-mumps-rubella shot.

Serious reactions, such as trouble breathing or a high fever
are rare. If you or your child has an unusual reaction, call your
doctor.

How safe are vaccines?

False claims in the news have made some parents concerned about a link between autism and the shot for measles, mumps, and rubella. But studies have found no link between vaccines and autism.1, 2

Some parents
question whether mercury-containing thimerosal (used as a preservative in
vaccines) might cause
autism. Studies have not found a link between
thimerosal-containing vaccines and autism.3 Today, all
routine childhood vaccines made for the U.S. contain either no
thimerosal or only trace amounts.4

Two major government agencies, along with vaccine makers and other groups, watch for, study, and keep track of adverse events that occur after vaccines are given.

Health Tools

Health Tools help you make wise health decisions or take action to improve your health.

Decision Points focus on key medical care decisions that are important to many health problems.

Childhood Immunizations

Recommended immunizations

The U.S. Advisory
Committee on Immunization Practices (ACIP), the American Academy of Pediatrics,
and the American Academy of Family Physicians recommend a specific
childhood immunization schedule each year.
Immunizations are recommended, because they protect
against diseases (give
immunity) or make a disease less severe if your child
does get it. The schedule outlines the immunizations and booster shots needed
from birth through age 18, as well as when catch-up
immunizations should be given.

Many immunizations require more
than one dose, given at varying intervals. Although your child does not need to
restart the series if a scheduled dose is missed, the immunization should be
given as soon as possible.

Immunizations recommended for children younger than 11 years of age include:5

Who should get it?

This immunization helps protect against
the flu. Flu viruses are always changing, so the flu
vaccines are updated every year.

Who should get it?

All people ages 6 months and older need one dose each year. Children younger than 9 years of age may need two doses depending on when they started getting this yearly immunization.

Healthy children ages 2 and older can usually get the
nasal spray form (FluMist)(What is a PDF document?) instead of the
flu shot(What is a PDF document?). Protection lasts up to a year for both vaccine types. For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.

This shot protects against bacteria that can cause an infection in the
lungs (pneumonia) or the covering of the brain (meningitis), skin and bone infections, and other
serious illnesses in young children. It does not protect against viral
influenza (flu).

Who should get it?

All children need three or four doses, starting at 2 months
of age and ending by 15 months of age.

Children who are older than 5 years and have certain health
conditions may also need this shot.

Who should get it?

All children starting at 1 year of age need two doses,
given at least 6 months apart.

Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs two doses. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6

Who should get it?

Two doses are given to all children—one at age 12 to 15
months and one at age 4 to 6 years.

There is a measles, mumps,
rubella, and varicella (MMRV, or ProQuad) shot that also protects against
chickenpox (varicella). Talk to your child's doctor about the pros and cons of the MMRV shot(What is a PDF document?). It can be given to children ages 12 months to 12 years.

Other immunizations

This shot protects against
a bacteria that causes
meningitis and blood infections (sepsis).

Who should get it?

Children who have a higher risk than other children for getting and having severe problems from meningitis need at least two shots. This includes children ages 2 months and older who have certain
immune system problems, children who have a damaged or missing
spleen, and children who live in or will travel to areas
of the world where the disease is common.

Children who remain at high risk need routine booster shots starting a few years after their first doses of meningococcal conjugate shots. Ask your doctor if your child has a high risk of getting infections from bacterial meningitis and whether booster shots are needed.

This shot does
not necessarily reduce the risk of getting
pneumonia. But it can prevent some of the serious
complications of pneumonia, such as blood infections (sepsis).

Who should get it?

Children ages 2 years and older who have certain chronic diseases, such as
diabetes or heart disease, need this shot at age 2 or as soon as possible after it is known that they have a chronic illness. This shot is usually given after the PCV series is finished.

Combination vaccines

Combination vaccines are
usually preferred to separate shots because they reduce the number of needle pricks.
Examples include:

Keeping good immunization records

It is important
to keep accurate records(What is a PDF document?) of immunizations, including any reactions to the
vaccines. When you enroll your child in day care or school, you may need to
show proof of immunizations. Also, your child may need the record later in life
for college, employment, or travel.

Know when each immunization should be scheduled, and put
reminder notes on your calendar. You also may want to ask your doctor to send
you notices when immunizations are due.

Have your doctor go over your child's immunization record with
you during each office visit.

Keep the record in a safe place, and never throw it away. It is
an important part of your child's lifelong medical records.

Immunization safety

You may worry that
immunizations are dangerous if given when your child has a cold or other minor
illness. Talk to your child's doctor if you have
concerns about the timing of immunizations. Immunizations can usually still be given during a mild illness,
while medicines are being taken, and in other situations where a child may not
be in perfect health. Also,
getting several vaccines at the same time is as safe
as getting one shot at a time.7 There are very few
reasons for which doctors suggest that a person
postpone or not get an immunization.

Some parents fear that the measles-mumps-rubella (MMR) vaccine may
cause their child to develop
autism. Misleading stories about the
MMR shot and autism have circulated through websites, the media, and word
of mouth. But scientific studies have found no
connection between autism and the vaccine.1

For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.

Adolescent Immunizations

Recommended immunizations

Adolescents need certain immunizations and booster shots for ongoing protection (immunity) against diseases. Consult your doctor or public health department if your child missed an
immunization or if you need to find out whether your child needs a certain one.

The U.S. Advisory Committee on
Immunization Practices (ACIP), the American Academy of Pediatrics, and the
American Academy of Family Physicians recommend a specific
immunization schedule for children and adolescents
each year.5 This schedule outlines the immunizations
and booster shots needed during adolescence and also when catch-up
immunizations should be given.

This immunization helps protect against the flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.

Who should get it?

All people ages 6 months and older need one dose each year.

Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?) instead of the flu shot. Pregnant women can get the flu shot but not
FluMist. People ages 18 to 64 can get the intradermal flu shot instead of the regular flu shot. The intradermal vaccine gets injected into the skin instead of the muscle. And it uses a much smaller needle than the regular flu shot.

For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.

Human papillomavirus (HPV)

The vaccines Cervarix(What is a PDF document?) and Gardasil(What is a PDF document?) protect against two types of human papillomavirus (HPV) that cause
cervical cancer. Gardasil also protects against two types of HPV that cause
genital warts. And it
protects against some uncommon cancers, such as vaginal cancer.

Who should get it?

All adolescents ages 11 or 12 need three doses of this shot, given over 6
months. (The series of shots can be started at age 9 or 10.)

Gardasil can be given to males.

Either Cervarix or Gardasil can be given to females.

Females 13 to 26 years
old who did not get it when they were younger should get this series of shots. Males 13 to 21 years old who did not get it when they were younger should get this series of shots.

If your child already has HPV infection, talk with
your doctor about whether to get your child immunized. The shot has not been shown to help
existing HPV infection, but it may protect your child from other HPV
infections.

Who should get it?

All preteens ages 11 or 12 need one Tdap shot.

All teens who haven't had the shot should get it as soon as possible.

Other immunizations

Some adolescents may need or
want additional immunizations for situations that increase a person's risk for
exposure to disease, such as being in group living situations (when attending
college or summer camp) or traveling to other countries. They may have missed shots when they were younger. Or a vaccine may not have been offered when they were younger. These immunizations
may include:

Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs this shot. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6

Who should get it?

This shot does
not necessarily reduce the risk of getting
pneumonia. But it can prevent some of the serious
complications of pneumonia, such as blood infections (sepsis).

Who should get it?

Adolescents with certain chronic diseases, such as
diabetes or heart disease, need this shot.

Immunization safety

Most side effects from
vaccines are minor, if they occur at all. The doctor may have your child stay
in the office for up to 15 minutes after the shots are given, to watch for any
reactions.

You may worry that immunizations are dangerous if
they are given when your child has a cold or other minor illness. Talk to your child's
doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where a child may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.

For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.

Adult Immunizations

Recommended immunizations

Your need for
immunizations does not end when you reach adulthood.
The specific shots (injections) you need as an adult depend not only on your age, lifestyle, overall health, pregnancy status, and travel plans
but also on who you are in close contact with and what vaccines you had as a child. Tetanus and diphtheria shots need to be
repeated every 10 years throughout adulthood in order to keep your
immunity.

Each year the U.S. Advisory
Committee on Immunization Practices (ACIP), the American College of Obstetrics
and Gynecologists, the American College of Physicians, the American Academy
of Family Physicians, and the American College of Nurse-Midwives recommend a specific
adult immunization schedule(What is a PDF document?). Your doctor will consider your
medical and immunization history (and documentation) when deciding which shots
you need.

This immunization helps protect against the flu. Flu viruses are always changing, so the flu
vaccines are updated every year. Protection lasts up to a year for each flu
vaccine type.

Who should get it?

All adults need one dose each year. It is especially important for:

People at higher risk of severe flu.

Close contacts of people who are at higher risk, including people who live with or care for children younger than 6 months.

Healthy people ages 2 years through 49 years can
usually get the
nasal spray flu vaccine (FluMist)(What is a PDF document?) instead of the flu shot. Pregnant women can get the flu shot but not
FluMist. People ages 18 to 64 can get the intradermal flu shot instead of the regular flu shot. The intradermal vaccine gets injected into the skin instead of the muscle. And it uses a much smaller needle than the regular flu shot.

Adults ages 65 and older can get a high-dose flu shot.9 Studies are being done to see if the high-dose shot protects older adults better than the standard-dose shot.

For the most current CDC guidelines about the flu, go to www.cdc.gov/flu.

Who should get it?

Anyone who will be in close contact with an adopted child from a country that has high rates of hepatitis A needs two doses. This includes household contacts and babysitters. This recommendation only applies for the first 60 days the child is in the United States.6

This shot protects against
hepatitis B disease. Three doses are needed over at least 4 months.

Who should get it?

Adults ages 19 to 59 who have diabetes need this shot if they have not had the shot before. This vaccine is optional for adults ages 60 and older who have diabetes and have not had the shot before.

Other adults who have not had this vaccine series need this shot when occupation, travel, health condition, or lifestyle
increases their risk of exposure.

A hepatitis combination vaccine (Twinrix) is recommended for those who
are at risk for both hepatitis A and hepatitis B. This vaccine is approved in
the United States only for those 18 years of age or older.

Pneumococcal

This shot does
not necessarily reduce your risk of getting
pneumonia, but it can prevent some of the serious
complications of pneumonia, such as infection in the bloodstream (bacteremia)
or throughout the body (septicemia).

Who should get it?

It's important to get the Tdap shot at least 2 weeks before having close contact with a baby.

Other immunizations

You may need or want
additional immunizations if certain situations raise your chance for
exposure to disease. Or you may have missed shots when you were younger. Or a vaccine may not have been offered when you were younger. These immunizations may include:

Human papillomavirus (HPV)

This is important if you never
got this shot.

The vaccines Cervarix(What is a PDF document?) and Gardasil(What is a PDF document?) protect against two types of human papillomavirus (HPV) that cause
cervical cancer. Gardasil also protects against two types of HPV that cause
genital warts. And it
protects against some uncommon cancers, such as vaginal cancer.

Who should get it?

Females 13 to 26 years old need either Cervarix or Gardasil if they did not get the shot when they were younger. Three doses are given over 6
months.

Males 13 to 21 years old need Gardasil if they did not get the shot when they were younger. Three doses are given over 6 months.

Males 22 to 26 years old who have a weak immune system or who have sex with men need Gardasil if they did not get the shot when they were younger. Three doses are given over 6 months.

If you already have HPV infection, talk with your
doctor about whether to get immunized. The shot has not been shown to help
existing HPV infection, but it may protect you from other HPV
infections.

This shot
protects against a bacteria that causes meningitis and blood infections (sepsis).

Who should get it?

Adults who have a damaged or missing
spleen or who have certain
immune system problems need two initial doses and then a booster dose every 5 years.

Adults who have a higher risk than
others for getting and having severe problems from meningitis need one shot. This includes adults who will travel or live in areas
of the world where the disease is common.

For adults up to age 55, the meningococcal conjugate vaccine (MCV) is usually given. Adults older than age 55 are immunized with the meningococcal
polysaccharide (MPSV4) vaccine, called Menomune. Some people may need booster shots.

Who should get it?

Adults whose travel or job puts them at increased risk for exposure
to polio need three doses of this shot.

Adults who never had the full series of oral polio vaccine (OPV) or inactivated polio vaccine (IPV) and who have an increased risk of being exposed to polio need the shots they missed.

Routine polio immunization is not recommended for
adults (ages 18 and older) who live in the United States.

Consult your doctor or public health department if
you missed an immunization or to find out whether you need a specific
immunization. For more information about each vaccine, see the topic
Vaccine Information Statements.

Immunizations and pregnancy

Before you become pregnant, discuss your immunization history with your doctor. Your
immunity protects both you and your baby. Some vaccines (such as the ones for flu and Tdap) can be given during pregnancy. Some vaccines need to be given before or soon after pregnancy.

If you are pregnant, your children should still
get their immunizations on schedule. You do not need to speed up or delay your
other children's immunizations.

Immunization safety

You may worry that
immunizations are dangerous if they are given when you have a cold or other minor
illness. Talk to your doctor if you have
concerns about the timing of shots. But keep in mind
that shots can usually still be given during a mild illness, while medicines
are being taken, and in other situations where you may not be in perfect
health. There are very few reasons for which doctors suggest that a person
postpone or not get an immunization.

For more information about vaccine safety studies and vaccine side effects, see the topic Immunization Safety.

Travel Immunizations

Recommended immunizations

Talk with your doctor
months in advance of a trip to find out whether any
immunizations are recommended. Certain things, such
as your age and health, where you are going, and the length of your stay,
affect your risk of disease and your need for immunization.

Your age and health

People with certain medical
conditions, such as
immune system problems, may have different
immunization recommendations than healthy people. Also, young children who are
traveling may need to receive their routine immunizations sooner than normally
scheduled.

Where you travel

In
most developed countries (including Canada, Australia, New Zealand, Japan, and
western and northern European countries), the risk of exposure to serious
diseases is generally no greater than it is in the United States.

The risk of exposure to serious disease may be much higher in developing
countries (such as those in most parts of Africa and Asia and many parts of
South and Central America) than it is in most developed countries. This is
especially true for areas with poor sanitation (for example, poor water and
food handling). For example:

If you are going to travel to South America or Africa, you may need the
yellow fever vaccine(What is a PDF document?).

The need for travel immunizations depends on your
immunization history, the specific area you plan to visit, the time of year,
and whether any outbreaks of disease have recently occurred.

How you travel and types of activities

Certain activities or modes of travel increase
your risk of exposure to disease. These include:

Exploring rural areas or those off the usual tourist
route.

Taking backpacking trips.

Visiting people in another country.

Length of stay

The
longer you stay in a country, the more exposure you have to local
pathogens that could cause harm.

More information

You can get information about
travel immunizations by:

Contacting your local health department or doctor.

Visiting the website of the Centers for Disease Control and
Prevention (CDC) at www.cdc.gov/travel.

For more information on immunizations and health related
to travel, see the topic
Travel Health.

Bioterrorism and Immunizations

The United States
government has developed plans on how to respond to possible bioterrorism
threats.

A 2007 law called the Pandemic and All-Hazards
Preparedness Act ("Bioshield II") will help companies make more vaccines and
drugs that protect against bioterror agents.10

Certain diseases have been identified that pose the greatest threat to
the U.S. public. At this time, there is a supply of anthrax and smallpox
vaccines only. These
immunizations are not currently available to or
recommended for the general public. But the government has advised immunization
for people at high risk of exposure to anthrax or smallpox, such as health care
workers specifically designated to respond to a bioterrorism emergency. Some of
these recommendations are listed below.

Who should get it?

This shot is for people at high risk of exposure, such as
certain lab workers, people who work with imported animals where preventive
standards are lacking (such as veterinarians who travel to work in other
countries), and certain military members.

Five shots are given over 18 months. And booster shots
are needed every year for continued protection (immunity).

Who should get it?

This shot is for certain health care and public health workers,
infection-control specialists, and certain military members.

This shot is given once as several quick punctures on
the upper arm, using a special prong device. Immunity after a first-time
immunization is likely to be 3 to 5 years. If you have been immunized in the
past, successful revaccination may extend your immunity.

The
United States has enough smallpox vaccine to vaccinate Americans in an
emergency.11

More information about these
immunization recommendations can be found on the Centers for Disease Control
and Prevention (CDC) website at www.bt.cdc.gov/bioterrorism. For general
information about bioterrorism issues, see the topic
Terrorism and Other Public Health Threats.

When to Call a Doctor

Call 911 or other emergency services if you or your child develops any of the following
symptoms:

Home Treatment

Help your child handle immunizations

Many
immunizations are given as shots (injections). Your
child may experience brief pain as the needle penetrates the skin or muscle.
Some vaccines cause more discomfort than others. In general, you can help
decrease your child's discomfort by making sure that
he or she is physically comfortable and well rested before getting immunized.
You can use home treatment measures to help relieve some of the common minor
reactions to immunizations.

Relieve mild reactions to immunizations

You can
help relieve some of the common, temporary, mild reactions to immunizations
with basic home care.

Fever. A slight
fever may occur after you or your child gets a shot.
Acetaminophen (such as Tylenol) or
ibuprofen (such as Advil) may help lower a fever. Follow the package instructions carefully. If you give medicine to your baby, follow your doctor's advice about what amount to give. Check with your doctor first if you are not sure your young
baby's fever is related to getting immunizations. Do not give aspirin to anyone younger than 20 because of the risk of
Reye syndrome, a rare but serious disease. For more information on fevers, see the
topic
Fever or Chills, Age 11 and Younger or
Fever or Chills, Age 12 and Older.

Swelling or redness. The area around the injection site may become red and
swollen. Apply a wrapped ice pack or cool compress to the area for about 10 to
20 minutes. If this does not reduce the symptoms, acetaminophen or ibuprofen may help relieve the discomfort. Follow the package instructions carefully.

Fretfulness and poor appetite. For a few hours after getting immunized, a baby may be fretful
and drowsy and may refuse to eat. Plan quiet activities at home for the evening
after your child receives an immunization. Hold and cuddle your child when
needed. Keep your home at a comfortable temperature, because your child is more
likely to be fretful if he or she gets too warm.

Skin rash. A mild skin rash may arise 7 to 14 days after your child gets
the chickenpox or measles, mumps, and rubella (MMR) shot. These types of rashes
can last several days and go away without treatment.

Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.

Centers for Disease Control and Prevention. (2011). Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book),
12th ed. Washington, DC: Public Health Foundation.
Also available online:
http://www.cdc.gov/vaccines/pubs/pinkbook/index.html.

Centers for Disease Control and Prevention (2010). Licensure of a high-dose inactivated influenza vaccine for persons aged ≥65 years (Fluzone high-dose) and guidance for use—United States, 2010. MMWR, 59(16): 485–486. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5916a2.htm?s_cid=mm5916a2_e.

Other Works Consulted

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adolescents. MMWR, 54(RR-16): 1–23. Also available
online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5416a1.htm. [Erratum in
MMWR, 55(06): 158–159. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5506a6.htm.]

Centers for Disease Control and Prevention (2006). A
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virus infection in the United States, Recommendations of the Advisory Committee
on Immunization Practices (ACIP) Part II: Immunization of adults.
MMWR, 55(RR-16): 1–33. Also available online:
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5516a1.htm. [Erratum in
MMWR, 56(42): 1114.]

Centers for Disease Control and Prevention (2006). Prevention of hepatitis A through active or passive immunization: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 55 (RR-7): 1–23. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5507.pdf.

Centers for Disease Control and Prevention (2007).
Prevention of varicella: Recommendations of the Advisory Committee on
Immunization Practices (ACIP). MMWR, 56(RR-4): 1–48.
Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5604.pdf.

Centers for Disease Control and Prevention (2008).
Prevention of herpes zoster: Recommendations of the Advisory Committee on
Immunization Practices (ACIP).
MMWR, 57(05): 1–30. Also available online:
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Centers for Disease Control and Prevention (2008).
Syncope after vaccination: United States, January 2005 to July 2007.
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Centers for Disease Control and Prevention (2009).
Prevention of rotavirus gastroenteritis among infants and children:
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Centers for Disease Control and Prevention (2010). Updated recommendations for prevention of invasive pneumococcal disease among adults using the 23-valent pneumococcal polysaccharide vaccine (PPSV23). MMWR, 59(34): 1102–1106. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5934a3.htm?s_cid=mm5934a3_e.

Centers for Disease Control and Prevention (2010). FDA licensure of bivalent human papillomavirus vaccine (HPV2, Cervarix) for use in females and updated HPV vaccination recommendations from the Advisory Committee on Immunization Practices (ACIP). MMWR, 59(20): 626–629. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5920a4.htm?s_cid=mm5920a4_e.

Centers for Disease Control and Prevention (2010). Prevention of pneumococcal disease among infants and children: Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine - Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 59(RR-11): 1–18. Also available online: http://www.cdc.gov/mmwr/PDF/rr/rr5911.pdf.

Centers for Disease Control and Prevention (2011). Recommendations on the use of quadrivalent human papillomavirus vaccine in males: Advisory Committee on Immunization Practices (ACIP). MMWR, 60(50): 1705–1708. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a3.htm?s_cid=mm6050a3_e.

Centers for Disease Control and Prevention (2011). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid and acellular pertussis (Tdap) vaccine from the Advisory Committee on Immunization Practices, 2010. MMWR, 60(01): 13–15. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6001a4.htm?s_cid=mm6001a4_w.

Centers for Disease Control and Prevention (2011). Use of hepatitis B vaccination for adults with diabetes mellitus: Recommendations of the Advisory Committee on Immunization Practices (ACIP)
. MMWR, 60(50): 1709–1711. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6050a4.htm?s_cid=mm6050a4_e.

Centers for Disease Control and Prevention (2012). Updated recommendations for use of tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccine in adults aged 65 years and older—Advisory Committee on Immunization Practices (ACIP), 2012. MMWR, 61(25): 468–470. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6125a4.htm?s_cid=mm6125a4_e.

Centers for Disease Control and Prevention (2013). Prevention and control of meningococcal disease: Recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR, 62(RR-02): 1–22. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6202a1.htm?s_cid=rr6202a1_x.

Centers for Disease Control and Prevention (2013). Prevention and control of seasonal influenza with vaccines: Recommendations of the Advisory Committee on Immunization Practices — United States, 2013–2014
. MMWR, 62(RR07): 1–43. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/rr6207a1.htm?s_cid=rr6207a1_w.

Centers for Disease Control and Prevention (2009). Updated recommendations from the Advisory Committee on Immunization Practices (ACIP) for use of hepatitis A vaccine in close contacts of newly arriving international adoptees. MMWR, 58(36): 1006–1007. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5836a4.htm?s_cid=mm5836a4_e.

Centers for Disease Control and Prevention. (2011). Epidemiology and Prevention of Vaccine-Preventable Diseases (The Pink Book),
12th ed. Washington, DC: Public Health Foundation.
Also available online:
http://www.cdc.gov/vaccines/pubs/pinkbook/index.html.

Centers for Disease Control and Prevention (2010). Licensure of a high-dose inactivated influenza vaccine for persons aged ≥65 years (Fluzone high-dose) and guidance for use—United States, 2010. MMWR, 59(16): 485–486. Also available online: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5916a2.htm?s_cid=mm5916a2_e.

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